Determinants of bone damage: An ex-vivo study on porcine vertebrae

PLoS One. 2018 Aug 16;13(8):e0202210. doi: 10.1371/journal.pone.0202210. eCollection 2018.

Abstract

Bone's resistance to fracture depends on several factors, such as bone mass, microarchitecture, and tissue material properties. The clinical assessment of bone strength is generally performed by Dual-X Ray Photon Absorptiometry (DXA), measuring bone mineral density (BMD) and trabecular bone score (TBS). Although it is considered the major predictor of bone strength, BMD only accounts for about 70% of fragility fractures, while the remaining 30% could be described by bone "quality" impairment parameters, mainly related to tissue microarchitecture. The assessment of bone microarchitecture generally requires more invasive techniques, which are not applicable in routine clinical practice, or X-Ray based imaging techniques, requiring a longer post-processing. Another important aspect is the presence of local damage in the bony tissue that may also affect the prediction of bone strength and fracture risk. To provide a more comprehensive analysis of bone quality and quantity, and to assess the effect of damage, here we adopt a framework that includes clinical, morphological, and mechanical analyses, carried out by means of DXA, μCT and mechanical compressive testing, respectively. This study has been carried out on trabecular bones, taken from porcine trabecular vertebrae, for the similarity with human lumbar spine. This study confirms that no single method can provide a complete characterization of bone tissue, and the combination of complementary characterization techniques is required for an accurate and exhaustive description of bone status. BMD and TBS have shown to be complementary parameters to assess bone strength, the former assessing the bone quantity and resistance to damage, and the latter the bone quality and the presence of damage accumulation without being able to predict the risk of fracture.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Absorptiometry, Photon
  • Animals
  • Bone Density
  • Compressive Strength
  • Disease Models, Animal
  • Humans
  • In Vitro Techniques
  • Lumbar Vertebrae / diagnostic imaging
  • Lumbar Vertebrae / injuries*
  • Lumbar Vertebrae / metabolism
  • Stress, Mechanical
  • Sus scrofa
  • X-Ray Microtomography

Grants and funding

The authors received no specific funding for this work. TECHNOLOGIC S.r.l. provided support in the form of salary for author LR, but did not have any additional role in the study design, data collection and analysis, decision to publish or preparation of the manuscript. The specific roles of the author are articulated in the author contribution section.